UHR、MHR、25（OH）D水平对2型糖尿病下肢动脉血管病变的诊断价值

doi:10.3969/j.issn.1006-5725.2026.07.017

Abstract

Abstract:

Objective To investigate the diagnostic value of uric acid/high-density lipoprotein cholesterol ratio （UHR）， monocyte count/high-density lipoprotein cholesterol ratio （MHR）， and 25-hydroxyvitamin D ［25（OH）D］ levels in lower extremity artery disease （LEAD） of type 2 diabetes mellitus （T2DM）. Methods This retrospective study analyzed 166 T2DM patients hospitalized at the Department of Endocrinology， Second Affiliated Hospital of Zhengzhou University from April 2024 to September 2025. Patients were categorized into T2DM with LEAD （82 cases） and T2DM without LEAD （84 cases） based on the presence of lower extremity artery disease. General demographics and biochemical markers were compared between groups. Logistic regression was used to identify risk factors for LEAD development， while Pearson correlation analysis evaluated the relationships between UHR， MHR， 25（OH）D， and other biochemical indicators. ROC curves were constructed to assess diagnostic value. Results The T2DM with LEAD group showed statistically significant differences （P < 0.05） compared to the T2DM without LEAD group in male proportion， age， disease duration， uric acid levels， monocyte count， UHR， and MHR， whereas high-density lipoprotein cholesterol （HDL-C） and 25（OH）D levels were lower in the former group. Pearson correlation analysis revealed negative associations between UHR and 25（OH）D， low-density lipoprotein cholesterol （LDL-C）， and total cholesterol （P < 0.05）， while showing positive correlations with serum creatinine and monocyte count （P < 0.05）. MHR exhibited negative correlations with LDL-C， total cholesterol， and non-HDL cholesterol （P < 0.05）.Univariate logistic regression analysis showed that gender， age， disease duration， UHR， MHR， and 25（OH）D were independent risk factors for LEAD in patients with T2DM. After adjusting for confounding factors such as gender， age， and disease duration. Multivariate logistic regression analysis identified UHR， MHR， and 25（OH）D as significant predictors of LEAD development in T2DM patients. ROC curve analysis demonstrated that the area under the curve （AUC） for diagnosing T2DM with LEAD using UHR， MHR， and 25（OH）D levels was 0.822，0.774， and 0.784 （P < 0.05）， respectively， with the combined use of these three markers yielded a significantly higher AUC reaching 0.927 （P < 0.05）， After internal validation by Bootstrap resampling， the corrected AUC was 0.921. Conclusion UHR， MHR， and 25（OH）D levels are key factors influencing LEAD development in T2DM patients， and their combined use significantly improves early diagnostic accuracy timely screening and intervention for LEAD complications.

Key words: type 2 diabetes mellitus, lower extremity artery disease, uric acid, monocyte count, HDL-C, 25（OH）D

CLC Number:

R587.1

Luping ZHANG,Jun LI,Yanqin FU. Diagnostic value of UHR， MHR， and 25-hydroxyvitamin D levels in lower extremity artery disease in type 2 diabetes mellitus[J]. The Journal of Practical Medicine, 2026, 42(7): 1243-1249.

Figures/Tables 6

Tab.1

Comparison of baseline data and biochemical indicators between the two groups"

变量	T2DM非LEAD组（n = 84）	T2DM合并LEAD组（n = 82）	x²/t/Z值	P值
年龄（ $x ˉ ± s$ ）/岁	59.99 ± 12.22	63.7 ± 10.89	-2.062	0.041
性别/[例（%）]			7.664	0.006
男	44（52.4）	60（73.2）
女	40（47.6）	22（26.8）
体质量（ $x ˉ ± s$ ）/kg	71.01 ± 14.36	71.67 ± 13.18	-0.310	0.757
身高（ $x ˉ ± s$ ）/m	1.68 ± 0.08	1.66 ± 0.09	-1.630	0.105
吸烟史/[例（%）]	21（25.0）	25（30.5）	0.624	0.430
饮酒史/[例（%）]	14（16.7）	20（24.4）	1.520	0.218
高血压史/[例（%）]	42（50.0）	43（52.4）	0.099	0.753
冠心病史/[例（%）]	26（31.0）	23（28.0）	0.168	0.682
病程/年	7（4,15）	11（5,20）	-2.286	0.022
BMI（ $x ˉ ± s$ ）/（kg/m²）	25.59 ± 3.83	25.2 ± 3.58	0.668	0.505
SBP/mmHg	130（128,135）	132（128,135）	-0.042	0.966
DBP/mmHg	74（70,80）	76（70,80）	-0.205	0.837
SUA（ $x ˉ ± s$ ）/（μmol/L）	265.02 ± 53.94	301.55 ± 79.05	-3.469	0.001
MHR	0.24(0.19,0.32)	0.35（0.29,0.47）	-6.088	< 0.001
UHR（ $x ˉ ± s$ ）	202.04 ± 59.55	286.53 ± 73.15	-8.169	< 0.001
25（OH）D（ $x ˉ ± s$ ）/（ng/mL）	23.6 ± 5.64	17.24 ± 6.27	6.879	< 0.001
HDL-C（ $x ˉ ± s$ ）/（mmol/L）	1.37 ± 0.32	1.08 ± 0.22	6.948	< 0.001
LDL-C（ $x ˉ ± s$ ）/（mmol/L）	2.7 ± 1.03	2.44 ± 0.92	1.727	0.086
TC/（mmol/L）	4.27（3.45,5.32）	3.99（3.17,4.72）	-1.743	0.081
TG/（mmol/L）	1.48（0.97,2.26）	1.44（0.97,2.09）	-0.165	0.869
non-HDL-C/（mmol/L）	1.44（0.97,2.09）	2.71（2.14,3.44）	-1.445	0.149
sdLDL-C/（mmol/L）	0.92（0.60,1.38）	0.85（0.55,1.17）	-1.149	0.251
MONO/（×10⁹/L）	0.33（0.25,0.42）	0.40（0.32,0.48）	-3.442	0.001
sCr（ $x ˉ ± s$ ）/（μmol/L）	66.94 ± 15.42	68.41 ± 13.23	-0.660	0.510
Cys C/（mg/L）	0.97（0.87,1.14）	1.00（0.89,1.18）	-0.838	0.402
BUN/（mmol/L）	6.14（5.10,7.40）	6.31（5.05,7.29）	-0.145	0.884
FPG/（mmol/L）	7.71（6.50,9.90）	7.52（6.27,9.02）	-0.567	0.571
HbA_1C/%	7.89（7.03,8.92）	7.69（6.59,9.10）	-0.186	0.853
C-P/（ng/mL）	2.73（2.08,3.90）	3.06（2.27,4.39）	-1.232	0.218

Tab.1

Tab.2

Tab.3

Tab.4

Fig.1

Tab.5

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变量	UHR		MHR		25(OH)D
变量	r值	P值	r值	P值	r值	P值
LDL-C	-0.166	0.032	-0.248	0.001	-0.129	0.097
TC	-0.254	0.001	-0.360	＜0.001	-0.049	0.528
Non-HDL-C	-0.138	0.099	-0.321	＜0.001	-0.065	0.436
sCr	0.207	0.007	0.140	0.072	0.008	0.920
MONO	0.242	0.002	-	-	-0.130	0.096
25(OH)D	-0.156	0.045	-0.133	0.088	-	-

变量	P值	OR	95%CI
性别	0.006	0.403	0.211 ~ 0.772
年龄	0.043	1.028	1.001 ~ 1.056
病程	0.028	1.043	1.005 ~ 1.082
UHR	< 0.001	1.020	1.014 ~ 1.027
25（OH）D	< 0.001	0.829	0.774 ~ 0.887
Ln_MHR*	< 0.001	15.800	5.850 ~ 42.673
SUA	0.001	1.009	1.003 ~ 1.014
HDL-C	< 0.001	0.012	0.002 ~ 0.058
Ln_MONO*	0.001	6.216	2.154 ~ 17.936

变量	AUC(95%CI)	P值	敏感度/%	特异度/%	约登指数	cut-off值
UHR	0.822(0.760 ~ 0.885)	< 0.001	84.1	66.7	0.508	215.32
25（OH）D	0.784(0.715 ~ 0.854)	< 0.001	58.5	90.5	0.490	17.74 ng/mL
MHR	0.774(0.702 ~ 0.845)	< 0.001	78.0	72.6	0.506	0.29
三者联合	0.927(0.887 ~ 0.966)	< 0.001	90.2	86.9	0.771	-

Diagnostic value of UHR， MHR， and 25-hydroxyvitamin D levels in lower extremity artery disease in type 2 diabetes mellitus

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变量	P值	OR	95%CI
UHR	< 0.001	1.020	1.011 ~ 1.030
25（OH）D	< 0.001	0.767	0.691 ~ 0.852
Ln_MHR*	0.004	7.664	1.897 ~ 30.965

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